High blood pressure. Carrying too much weight. Diabetes. A family history of heart attacks. These are things everyone knows make you more likely to have a heart attack. You might be surprised, though, at some of the lesser-known things which also raise your heart attack risk.

Are you taking ibuprofen or using antibacterial soap? You might want to switch to a natural product.

Did you have a triple cheeseburger and fries for lunch? The old phrase “heart attack on a bun” might be right on target—but not for the reasons you expect. Below are 15 little-known triggers that can raise your risk of a heart attack, and sometimes even double it. They just might make you look at your habits in a whole new light.

Trigger #1: Getting angry

A 2015 Australian study found that people were more likely to have heart attacks in the two hours following an episode of intense anger. Those who said they’d been, “furious,” “enraged,” or “out of control” were eight and a half times more likely to have a heart attack than people who hadn’t been angry. The more often they reported being angry, the higher the risk. If you needed a good reason to stop and count to ten, take note.

Trigger #2: Shoveling snow

It’s not just an old wives’ tale—shoveling snow really can make you have a heart attack. The combination of hard physical activity and cold can be lethal, especially if you’ve already had one heart attack. If you have heart disease, high blood pressure, or you’re not physically active, don’t risk it. Let it snow, let it snow, let it snow—and pay the neighbor kid to shovel instead.

Trigger #3: An especially heavy meal

“Heart attack on a bun” might be going a bit far, but having an unusually big meal significantly ups your risk of a heart attack. And I don’t mean doing it on a regular basis. A 2000 study from the VA found that people who already at risk were four times more likely to have a heart attack within two hours of a heavy meal. Why? That’s still an open question.

Trigger #4: Intense anxiety

The same study linking anger and heart attacks showed an even higher risk for people who reported acute anxiety. Anger and anxiety both raise your heart rate and blood pressure, make your blood vessels constrict, and make your blood more likely to clot. All these factors make a heart attack more likely. If you have issues with anxiety, anger, or stress, a stress- or anger-management program could be a literal life saver.

Trigger #5: Using antibacterial soap

I’ve been preaching against antibacterial soaps for years. They’re tied to thyroid problems, antibiotic-resistant germs, and cancer. Now research shows that triclosan, the active ingredient, actually kills heart muscle. Throw this poison away and stick to good old-fashioned soap without the extra toxins.

Trigger #6: Traffic jams

Could it be that any situation that causes strong negative emotions affects your heart? A German study finds that if you’re stuck in a traffic jam, you’re more than three times as likely to have a heart attack than if your drive is smooth.

Trigger #7: Heartburn drugs

Big Pharma doesn’t give a damn if you end up in the hospital—that just means they can sell you more drugs. Maybe that’s why no one warns you that Nexium, Prilosec, and Prevacid can up your heart attack risk by as much as twenty-one percent. This figure comes from a truly huge study by Stanford University of nearly 3 million people. Older heartburn drugs like Tagament, Pepcid, and Zantac, on the other hand, didn’t hold the same danger.

Trigger #8: Daylight savings time

Trigger #9: Having a drink

While a daily glass of wine might be good for your heart long-term, the short term effect may be just the opposite. Although your heart attack risk decreases by about 14% within 24 hours of drinking alcohol, the first hour after that drink could be dangerous. A study in Epidemiology found that the likelihood of a heart attack soared by a frightening 72% during the first hour after drinking. The reason isn’t clear, but speculation is that it might be due to increased blood pressure and a greater likelihood of clots.

Trigger #10: Taking ibuprofen or naproxen

Although they’ve been over-the-counter meds for years, the FDA now warns that these two drugs definitely raise your heart attack and stroke risk—even if you’re perfectly healthy. No dose is truly safe, and the more often you take them the greater the risk.

These are all good reasons to look at some lifestyle changes. Slow down. De-stress. Replace some of your toxic cleaners with more natural and healthy alternatives. And before you take anything Big Pharma has to offer, ask a million questions about the risks, benefits, and side effects. Your heart will thank you.

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